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Metallic elements were detected in maternal plasma collected in the first trimester using inductively coupled plasma\u2012mass spectrometry. The effect of maternal exposure on the risk of PTB was investigated using logistic regression, least absolute shrinkage and selection operator, restricted cubic spline (RCS), quantile g computation (QGC)\u00a0and Bayesian kernel machine regression (BKMR). Vanadium (V) and arsenic (As) were positively associated with PTB risk in the logistic model, and V remains positively associated in the multi\u2010exposure logistic model. QGC analysis determined V (69.42%) and nickel (Ni) (70.30%) as the maximum positive and negative contributors to the PTB risk, respectively. BKMR models further demonstrated a positive relationship between the exposure levels of the mixtures and PTB risk, and V was identified as the most important independent variable among the elements. RCS analysis showed an inverted U\u2010shape effect of V and gestational age, and plasma V more than 2.18\u2009\u03bcg\/L was considered a risk factor for shortened gestation length. Exposure to metallic elements mixtures consisting of V, As, cobalt, Ni, chromium\u00a0and manganese\u00a0in the first trimester was associated with an increased risk of PTB, and V was considered the most important factor in the mixtures in promoting the incidence of PTB.<\/jats:p>","DOI":"10.1111\/mcn.13682","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T09:35:51Z","timestamp":1719221751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of exposure to multiple metallic elements in the first trimester of pregnancy on the risk of preterm birth"],"prefix":"10.1111","volume":"20","author":[{"given":"Ting","family":"Wu","sequence":"first","affiliation":[{"name":"The International Peace Maternity and Child Health Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China"},{"name":"Shanghai Key Laboratory of Embryo Original Diseases Shanghai 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